| Background:The National Hygienic.City is a kind of state-level excellent city which is initiated and named by the National Patriotic Health Campaign Committee,representing the regional environment and health level.The development of the Hygienic City Initiative refers to the comprehensive social management,which mainly focuses on the role in promoting the construction of urban health infrastructures,enhancing urban health management,improving the urban environment,as well as improving residents' health.China's Hygienic City Initiative was implemented across the country in 1989.It has been the focus of the domestic scholars how to evaluate the development of the Hygienic City policy scientifically,find the existing problems in the implementation of the policy,and determine whether the expected effect of the policy has been achieved or not.The evaluation of China's Hygienic City Initiative belongs to the theoretical category of public policy evaluation.Public policy evaluation is an essential step in the whole process of policy analysis.Selection of scientific evaluation tools could promote democratic policy decision-making,and effective evaluation on the value of policies,so as to determine whether the policies should be continued,changed or terminated,and finally,improve the quality of policy implementation.Regarding the current evaluation model of public policy,the commonly used systematic classification framework is the one proposed by the German scholar Evert Vedung in 1997,including effect model,economic model,and professional model.The "customer" oriented model is one of the effect models,which locates at the target group of the policy,and aims to get the options of "customers"(target group)on the policy.Within the 30 years since the China's Hygienic City Initiative,domestic scholars have explored different aspects such as creation experience,methodology,and policy effects.The focus of the evaluation in these explorations are mostly based on the effect model,and a relatively mature evaluation methods and index system has been formed.However,the overwhelming majority of these evaluations emphasize the effect of policy implement from the perspective of policy makers or practitioners.There is a scarcity of systematic evaluation methods and tools from the perspective of the population covered by the policy to measure the actual access of residents in the implement of China's Hygienic City policy.The attitude of target groups has an critical influence on whether public policies can achieve the expected goals.Evaluation on residents' sense of acquisition is a new attempt and exploration under the "customer" oriented model in China.The sense of acquisition refers to the satisfaction of people's needs in a certain social environment,and emphasizes the cognitive and emotional experience that arises from the physical and spiritual gains,as well as the maintenance and realization of benefits.The word "sense of acquisition"was first put forward by President Xi Jinping and has become an important indicator to measure the life quality of Chinese people.Residents' sense of acquisition evaluation emphasizes whether the concerns,expectations,and needs of the target group are met.Residents' value standards are based on their personal interests,thus,evaluation of residents' sense of acquisition represents democracy and participation,and plays a good supplementary role to the traditional evaluation.Objective:From the perspective of the population covered by policy,this study aims to:1)establish a theoretical framework for the assessment model of the residents' sense of acquisition in China's Hygienic City Initiative,2)develop assessment tools,3)conduct applied research to provide scientific and reliable evidence for the evaluation of residents' sense of acquisition.Methods:1.The establishment of the theoretical framework for the evaluation of residents'sense of acquisition in China's Hygienic City Initiative The policy content released at the national level since 1989 were analyzed using the methods of text quantitative research to explore the policy characteristics over time,as well as the policy objectives and evaluation focus in different stages.The concept and connotation of residents' sense of acquisition from the perspective of residents feeling were also considered into establishment of the theoretical framework for the evaluation of residents' sense of acquisition in China's Hygienic City Initiative.2.Development of evaluation tools for residents' sense of acquisition in China's Hygienic City policy.The content of the scales were determined both by qualitative research methods(such as policy analysis,literature research,expert consultation,and personal interviews),and quantitative research methods(such as discrete trend method,critical ratio method,correlation coefficient method,factor analysis method),based on the main measures and the theoretical framework for the evaluation of residents' sense of acquisition in China's Hygienic City Initiative.Principal component analysis of exploratory factor analysis was used to construct the dimensions of the scales.The reliability and validity of the scales were evaluated from internal consistency reliability,split-half reliability,content validity,surface validity,and structural validity evaluation methods.Finally,a set of scales suitable for evaluating the residents' sense of acquisition were constructed,including the sub-scales on residents' recognition of policy measures,residents' perception of the policy environment,and residents' satisfaction with the effect of policy implementation.3.Application research for residents' sense of acquisition in China's Hygienic City InitiativeResidents from 61 hygienic cities randomly selected were investigated from the three aspects:the recognition of the policy measures,perception of the built environment,and satisfaction with policy implementation,by the abovementioned established evaluation scales for residents' sense of acquisition.The assessment on the applicability and feasibility of the scale and the descriptive analysis on the current status of residents'sense of acquisition in China's Hygienic City Initiative were carried out.Considering the three dependent variable reflect the different aspects of the residents' sense of acquisition respectively,multivariate response model with multiple levels was fitted to explore the influencing factors of the residents'sense of acquisition in China's Hygienic City Initiative.Results:1.The theoretical framework for the evaluation of residents' sense of acquisition in China's Hygienic City InitiativeA total of 119 policy texts related to China's Hygienic City since 1989 were included in this study.According to the analysis of policy text and the theory of public policy operation cycle,the policy implementation of the Hygienic City has experienced three phases:1)the policy planning stage,the policy measures adopted at this stage are mainly policy planning and content adjustment;2)the policy implementation stage,the main measures taken at this stage are various incentives such as "naming" and "re-examination";3)the policy outcome stage,the measures taken at this stage are mainly the policy evaluation and repositioning.Therefore,the evaluation of residents' sense of acquisition in China's Hygienic City Initiative should be an evaluation of the entire operating cycle including the above three stages.This study defines the theoretical framework of residents' sense of acquisition in China's Hygienic City Initiative as the following three aspects:1)residents' sense of acquisition in the policy planning stage,which is reflected in the degree of residents' recognition of the policy measures;2)the residents' sense of acquisition in the policy implementation stage,which is reflected in the residents'perception of the policy built environment;3)the residents'sense of acquisition in the policy outcome stage,which is reflected in the residents' satisfaction with the implementation of the policy.2.The development of evaluation tools for residents' sense of acquisition in China's Hygienic City policy.A set of scales suitable for evaluating the residents' sense of acquisition were constructed,including the evaluation scale of residents' recognition of policy measures,residents' perception of the policy built environment,and residents' satisfaction with the effect of policy implementation.The recognition evaluation scale includes 4 dimensions and 20 items,the perception evaluation scale includes 5 dimensions and 22 items,and the satisfaction evaluation scale includes 4 dimensions and 20 items in total.In terms of reliability evaluation,the Cronbach's a coefficient of the recognition evaluation scale,perception evaluation scale and satisfaction evaluation scale were all greater than 0.8,with the value at 0.90,0.88,and 0.91,respectively With respect to the dimensions of each scale,the Cronbach's a coefficients of different dimensions in the three scales are all over0.65,except the basic urban functions(number of items=3;Cronbach 's ?=0.59),urban environmental sanitation(number of items=4;Cronbach's a=0.53),urban social convenience(number of items=2;Cronbach's ?=0.40)in the perception evaluation scale.The Spearman-Brown splitting coefficient is used to calculate the correlation between the two parts.The results show that the Spearman-Brown splitting coefficients of the three scales are all greater than 0.70.In terms of validity evaluation,the research results show that the three scales all have good content validity and surface validity.The cumulative variance contribution rates of common factors extracted from the three scales are all greater than 50%.The factor load of items in the three scales are all greater than 0.40,except the item "A6.1 garbage classification collection".The path coefficient analysis results show that the P values of all the parameters in the three scales are less than 0.01,and the difference are all statistically significant.There are no items with path coefficients less than 0.32,and the path coefficients of most items are greater than 0.50.The goodness-of-fit model test showed that the goodness-of-fit indexes of the three scales were all within the range of ideal values.3.Application research for residents' sense of acquisition in China's Hygienic City InitiativeA total of 2,465 valid questionnaires were included in this study,and the qualified rate of the recovered questionnaires was 89.40%.The average answering time of the respondents was 9.50 minutes,and 94.08%respondents thought the items in the questionnaire were clear and easy to understand.The total score of residents' sense of acquisition in China's Hygienic City Initiative was 231.15±32.45,and the scores of the recognition,perception and satisfaction evaluation were 88.01 ±9.35,73.99± 16.45 and 69.14±13.24,respectively.After converting the scores according to the standard method,the results show that the recognition evaluation score(85.02)is the highest,followed by the satisfaction evaluation score(61.42),and the perception evaluation score(59.08).The influencing factors of the residents'sense of acquisition in China's Hygienic City Initiative were explored using the multivariate response model with multiple levels.The results of the empty model fitting showed that the variation of recognition scores,perception scores,and satisfaction scores were all statistically significant both at the individual level and the city level.The results of model fitting with the inclusion of explanatory variables showed that the main influencing factors of recognition evaluation were high school education or above,female,married status,aged 30 or above,regular physical exercise,and the good self-rated health status;the main influencing factors of perception evaluation were the lower annual average concentration of PM2.5,the higher green coverage rate of the built-up area and per capital GDP,living in the new comprehensive community,regular physical exercise,and the good self-rated health status;the main influencing factors of satisfaction evaluation were the lower annual average concentration of PM2.5,the higher green coverage rate of the built-up area and per capital GDP,living in the new comprehensive community,high school education or above,regular physical exercise and the good self-rated health status.Conclusions:1.This study defines the theoretical framework of residents' sense of acquisition in China's Hygienic City Initiative as the following three aspects,the residents' sense of acquisition in the policy planning stage to reflect in the degree of residents' recognition of the policy measures,the residents' sense of acquisition in the policy implementation stage to reflect in the residents'perception of the policy built environment,and=the residents' sense of acquisition in the policy outcome stage to reflect the residents' satisfaction with the implementation of the policy.2.The scales of residents' sense of acquisition in China's Hygienic City Initiative developed in this study have a good reliability and validity,with clear content,high acceptability,and strong practicability in practical application,which are able to effectively measure the residents' sense of acquisition in China's Hygienic City Initiative.3.The total score of residents' sense of acquisition in China's Hygienic City Initiative was relatively high,among which the recognition evaluation score is the highest,followed by the satisfaction evaluation score,and the lowest score is the perception evaluation score.4.In terms of influencing factors at the city level,the lower concentration of inhalable fine particles,the higher per capita GDP and the green coverage in built-up areas have a greater impact on residents' perception and satisfaction to the policy implementation;in terms of individual-level influencing factors,the type of residents' living community,regular physical exercises,and the good self-evaluation health status all have different effects on residents' recognition,perception,and satisfaction,while age,gender,marital status,and so on,only have an impact on residents'recognition. |
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